Dr, Armas has spent considerable time developing her research and professional career by completing a clinical endocrinology fellowship, becoming American Board of Internal Medicine certified in Endocrinology, Diabetes and Metabolism, and completing, presenting and publishing clinical research projects. Her long- term goals are to be an academic physician-scientist conducting clinical translational research in the field of bone disease and to be expert in state-of-the-art methods of bone analysis. This mentored K award includes a Masters of Public Health with a concentration in biostatistics and epidemiology. It is also focused on the technological skills needed in the bone research field, including training in transilial bone biopsy procedure, histomorphometry, micro-computed tomography (micro-CT), and peripheral quantitative computed tomography (pQCT). Creighton University Osteoporosis Research Center is a unique place to study bone with over 45 years of clinical research experience. Dr. Robert R. Recker has been instrumental in furthering research in the bone field. The skills and and knowledge needed to build an academic career in research are being used every day by dozens of people in and affiliated with the research center. This mentored research project is designed to use the technological skills and knowledge of statistical design and research and apply them to the problem of bone disease in patients with diabetes. This is a prospective, case-control study of diabetic subjects using DXA, bone markers, pQCT, histomorphometry, and micro-CT of transilial bone biopsies. This human study is designed to elucidate the effect of Type 1 diabetes on 1) bone remodeling, including histomorphometric and biochemical measures of bone formation and resorption, and 2) on structure, including micro-architectural arrangement of trabeculae and bone mineral density. RELEVANCE (See Instructions): Diabetics have higher rates of fracture than the general population. The mechanism is uncertain. Studies of human bone mass and rat. models of diabetes point to reduced bone turnover that leads to fragility and fractures. This has not been shown in humans. This will be the first study in humans of diabetic bone disease using histomorphometry, micro-CT and pQCT to elucidate the mechanisms of bone fragility. This will lead to further research in prevention and treatment of bone disease in patients with diabetes.